The pleading eyes

I'm enjoying Paeds. The kids are great.

I saw a few uncommon/ rare cases: Williams syndrome, Marfan syndrome, Cockayne syndrome and congenital ichthyosis.

The other day, I was helping a HO hold down a 4-year-old boy during blood-taking. As in every blood-taking in Paeds, the whole scene will be full of drama, especially when the kid is a toddler or an older child. They are old enough to know it hurts and will resist with all their might. I was both heart-broken and amused with this boy. He had so many antics. A few times, he tried screaming at the top of his voice. Then he used the gentle technique. He gave the HO the most soft and pleading eyes and begged the doctor "Doktor, jangan ambil darah...Doktor, jangan ambil darah." To which the HO very gently and firmly replied "Saya mesti. Saya hendak tolong kamu." His pleading failed and he tried to bluff us. He shouted "Saya nak pergi tandas...nak kencing." We were almost fooled until the mom said "Apa nak pergi tandas...ada pampers tu.." He was wearing a diaper. Super LOL! Another HO tried to fool him while trying to search for a nice, fat vein by saying "Tiada cucuk...tengok saja." The smart boy saw the SYRINGE (not even the needle, cuz we have hidden the needle) and said "Tu....tu...jarum!"    AND after the successful blood-taking, he refused to believe us when we told him that it's over and asked "Mana darah...nak tengok darah..."

Kids are amazing. Treating children is amazing. You will never feel cheated as you would treating an asthma patient who smokes or a HIV patient who continues to have UNprotected sex. It requires so much more skill and tact in Paeds. You need to be soft and gentle BUT firm at the same time. Plus you need to speak in that special kiddy voice that you reserve only for them. And you CANNOT NOT smile. So no matter how crappy a day you are having, the kids will make you smile, either voluntarily or involuntarily.

Can you resist that soft, pleading eyes?

Floater

42 days to Professional Exams II

And I feel like a floater...Like floaters in the vitreous humor. I am revising Ophthalmology, hence the Ophthalmological jargon. Floating around, reading whatever I can, whenever I can, grabbing whatever knowledge that is floating my way... If only whatever I read could stay ingrained in my memory and not leak out the moment I close the book. How nice if I could be like the big fishes in the sea where they could feed by just opening their mouth and all the plankton would float into their mouth. In my context, how nice if I could just stare or look at the book and all the knowledge would just flow straight into my memory.

It's a good thing, though, that I am still floating and not sinking. Think positive! Think positive! 

The nerd talking

I listened in awe as Dr Hamed explained splenorrhaphy to us today. If I wasn't making a conscious effort to keep my mouth closed, I would have listened with my mouth wide opened in wonder. I didn't know such a thing as splenorrhaphy existed until today. Till then, I thought that once liver or splenic laceration or rupture occurs, there's no other way other than splenectomy (for spleen) or death (if liver rupture). Until we learned of these. Listen to this...

In case of liver laceration, you can do a finger hepatectomy to actually widen the laceration and then, attempt to ligate the bleeding arteries between the laceration. (There are other methods of repairing the liver injury too which are the common ones that you've probably heard of.)

For splenic laceration, you can actually 'suture' the spleen together by using the omentum. As it is not possible to directly suture the spleen together due to its consistency, you can use the omentum and bring it over the lacerated area and tie the suture through the omentum. Other than omentum, you can use other materials too, which I am not very sure of. And this is SPLENORRHAPHY. How awesome is that!!! You can also use this method to repair liver laceration.

I know that these knowledge are beyond my level. I don't even have the knowledge of anatomy and physiology of liver and spleen at the tip of my fingers. But occasionally, I need out-of-the-world, mouth-gaping knowledge like these to remind me why Medicine is so fascinating. The stress of assignments, studying for endless exams, drilling by lecturers day after day can make life dull and lustre-less. And the occasional infusion of exciting information and knowledge can add some spice back to the otherwise, dull life.

The 4 hours of class with Dr Hamed today ended with me feeling all hyped up and excited. Like I am ready to storm into the OT and stand through surgery after surgery. Padahal, kalau ditanya anatomy questions, my excited bubble would probably burst terus.

Anyhow, today was great. Because of that class. And because it's FRIDAY!

Week 2

Week 2 in surgical posting

Surgery is fun and relaxing.

Standing for hours watching surgeries is taking a toil on my back and leg veins. I can almost feel my varicose veins worsening. Seriously contemplating the options for treatment should they worsen. I was kidding around with Nadiah- When people asked me next time why I didn't end up pursuing surgery, I will tell them "Oh because I don't want to get varicose veins."

The hospital and OR are Brrr-rrr Cold, a big difference from previous Medicine posting, when I was soaked with sweat which would turn into dried sticky sweat with dust and oil on my face, and then began sweating again- the cycle of sweat-- dried sweat--- sweat the whole day- Something I am glad to be rid of now.

Miss Saw is great. Love her teaching and was not as fearsome as people say and certainly not as terrifying as  Dr Snake from O & G last time. But still, she has an infamous reputation. People who work alongside her are known and bound to get SAWED by her, literally di-gergaji. But I still think her teaching is awesome though she is quit fussy. Well, as Dr Soo said, as doctors, we should be more fussy. We would want a fussy doctor to treat us or our family members. Hmmm...but I still hear of some ridiculous rules which she is said to demand of us from our clinical skills. Might have to conclude my impression of her later on.

Have not experienced the awesomeness of the mighty Mr Chuah. I am totally ready to be awed and inspired.

Noticed the ratio of female surgeons to male surgeons is very low. And the ratio of female training specialists/ MO to male is even lower. I also noticed of all the 3 female surgeons, one is single and one is nulliparous (don't know if she is married, she only told us she is nulliparous...lol). Don't know the marital status of the other one. As much as I aspire to be a surgeon, I also want to have a family.

I can't seem to finish my presentation on Painful Scrotum due tomorrow morning. :(

Oh and most importantly, there are many cute MOs in Surgery. I may have a new infatuation, mainly because the old one, who is supposed to be in Surgery too, is nowhere to be seen. So, what choice do I have but to find a new one? HAHA. Hiao-nya aku.